Yang Seoghwan, Cho Jin-Yong, Shim Woo-Chul, Kim Sungbeom
Dept. of Oral & Maxillofacial Surgery, Gachon University Gil Medical Center, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon, 21565, South Korea.
Maxillofac Plast Reconstr Surg. 2021 Oct 1;43(1):36. doi: 10.1186/s40902-021-00311-9.
The aim of this study is to evaluate the postoperative stability of zygomaticomaxillary complex (ZMC) fractures according to the number of fixation sites and to investigate the direction of postoperative displacement of the unfixed part of the fractured segment.
This study was retrospectively performed on 38 patients who were treated by open reduction and internal fixation of ZMC fractures and were taken postoperative computed tomography (CT) between February 2012 and July 2019. The patients were classified into 3 groups: 1-point fixation, 2-point fixation, 3-point fixation according to the number of fixations. The postoperative displacement of the fractured segment was evaluated by the superimposition between postoperative CT and follow-up CT, and the postoperative stability according to the fixation sites was investigated through the amount of postoperative displacement. In addition, it was investigated in which direction the location of the fractured segment was changed in the unfixed fractured segment according to the fixation sites.
The amount of postoperative displacement of the fractured segment was 0.75 ± 1.18 mm on average. In the postoperative displacement of the distal area according to the number of fixation of the fracture, there was no statistically significant difference in the amount of displacement of the fracture (p = 0.574). As for the direction of the change in the location of the fractured segment, 12 patients among 38 patients with the change in the location of the fractured segment were investigated, and the displacement in the medial direction (n = 11, 91.67%) was the most common in all three fixation methods.
In patients with a ZMC fracture who were treated by open reduction and internal fixation, the number of fixations did not make the difference in the postoperative displacement of the fracture. In addition, the fractured segment mainly changes in the medial direction after surgery, and this fact can be used as a reference for the reduction direction during surgery for the stable prognosis.
本研究旨在根据固定部位的数量评估颧上颌复合体(ZMC)骨折术后的稳定性,并研究骨折段未固定部分术后移位的方向。
本研究回顾性分析了2012年2月至2019年7月间38例接受ZMC骨折切开复位内固定治疗并进行术后计算机断层扫描(CT)的患者。根据固定数量将患者分为3组:单点固定、两点固定、三点固定。通过术后CT与随访CT的叠加评估骨折段的术后移位情况,并通过术后移位量研究根据固定部位的术后稳定性。此外,还根据固定部位研究了骨折段在未固定骨折段中的位置在哪个方向发生了变化。
骨折段术后平均移位量为0.75±1.18mm。根据骨折固定数量,在骨折远端区域的术后移位中,骨折移位量无统计学显著差异(p=0.574)。至于骨折段位置变化的方向,对38例骨折段位置有变化的患者中的12例进行了研究,在所有三种固定方法中,向内侧移位(n=11,91.67%)最为常见。
在接受切开复位内固定治疗的ZMC骨折患者中,固定数量对骨折术后移位无影响。此外,骨折段术后主要向内侧变化,这一事实可为手术复位方向提供参考,以实现稳定的预后。